A prospective study of catheter-related complications in HPN patients

Lyn Gillanders, Katherina Angstmann, Patrick Ball, Margie O'Callaghan, Andrew Thomson, Theodoric Wong, Mark Thomas

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Abstract

Background & aims: Central venous access device (CVAD)-related complications such as catheter-related sepsis, occlusion and breakage contribute to both mortality and morbidity in home parenteral nutrition (HPN) patients. Prospectively collected data in these patients are scarce.

Methods: Data on all CVAD-related complications in four tertiary referral centres in Australia and New Zealand were prospectively collected between 01/01/2009 and 31/12/2009 together with costs of each episode that required admission.

Results: Of 53 patients (42 adults and 11 children), 27 suffered a total of 49 episodes of CVAD-associated complications (line infection 36, catheter blockage 5, line fracture 1, line migration 7), giving an incidence of 3.6 per 1000 CVAD days (11.6 per 1000 in patients with a multi-use CVAD). Thirty seven episodes resulted in hospital admission for a median duration of 8 days (range 1–29). Responsible microbes were mainly enteric with klebsiella being the most commonly isolated organism (10 episodes).

The average cost of care per episode of CVAD-associated complication requiring inpatient admission was $A9,710 (€6480 approximately).

Conclusion: CVAD complications, in particular line infection are still a major source of potentially avoidable HPN morbidity and mortality with a high cost to the healthcare system. The predominance of enteric organisms in our series raises the possibility of bacterial translocation as a significant component of the pathogenesis of line sepsis in HPN patients.

Original languageEnglish
Pages (from-to)30-34
Number of pages5
JournalClinical Nutrition
Volume31
Issue number1
DOIs
Publication statusPublished - Feb 2012
Externally publishedYes

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Gillanders, L., Angstmann, K., Ball, P., O'Callaghan, M., Thomson, A., Wong, T., & Thomas, M. (2012). A prospective study of catheter-related complications in HPN patients. Clinical Nutrition, 31(1), 30-34. https://doi.org/10.1016/j.clnu.2011.09.009